nunavut infant mortality rate

statement and Dark purple tones indicate regions with high infant mortality rates and correspondingly light purple tones indicate regions with low infant mortality rate. Results from surveys of Nunavut mothers suggest that only 38-46% of mothers place their infants to sleep on their backs, compared to 77% for the rest of Canada [16, 17]. In cultures such as the Inuit culture, where mothers traditionally and continue to prefer to bed-share with infants, advising against bed-sharing under all circumstances may not be easily accepted. startxref On-going research will address this limitation. Bonnefont J-P, Demaugre F, Prip-Buus C, Saudubray JM, Brivet M, Abadi N, Thuillier L: Carnitine palmitoyltransferase deficiencies. Mol Genet Metab. At this time we cannot rule out or confirm an associated risk with the P479L allele given our small numbers. 0000085603 00000 n Undiagnosed fatty acid oxidation disorders account for 3-6% of SIDS and SUDI cases [15, 20, 21]. Below are the links to the authors’ original submitted files for images. Although prenatal maternal smoking was not well documented in the data available for this review, in other studies 60-80% of Nunavut women self-reported smoking during pregnancy, almost 5 times the national average of 13% [43, 44]. �=@N�L F��{�xw�칂�"��=YPg 9�G\�-.��m�]��u��!�Q@zȕ��P�[�eeq��]+y�t��غl�Y��[\��\��y��[��ja��L�H��Ӹ`�K��Q�v��v�f[��#el]��P��\� The hospitalization rate for infants with heart defects is even higher at 800/1,000 infants. This was a retrospective case review with incomplete risk determinant information. 2004, 63: 251-266. Chace DH, DiPerna JC, Mitchell BL, Sgroi B, Hofman LF, Naylor EW: Electrospray tandem mass spectrometry for analysis of acylcarnitines in dried postmortem blood specimens collected at autopsy from infants with unexplained cause of death. Nunavut’s infant mortality rate is nearly five times higher than the national average. In our review, P479L homozygosity was associated with unexpected infant death (SIDS/SUDI and infection) in Nunavut as a whole (OR 3.43, 95%CI:1.30-11.47; p=0.006), which is consistent with results reported for Alaska Native and British Columbia First Nations populations [22, 23]. 10.1016/j.ymgme.2008.12.018. Paediatr Child Health. Google Scholar. To study the Inuit infant mortality rate, University of Montreal researcher Dr. Zhong-Cheng Luo looked at all four million births in Canada between 1990 and 2000. To determine the causes and potential risk factors of infant mortality in Nunavut, we reviewed all infant deaths (<1yr) documented by the Nunavut Chief Coroner’s Office and the Nunavut Bureau of Statistics (n=117; 1999–2011). Nunavut's infant mortality rate was calculated as 21.4 per 1,000 live births. The infant mortality rate in Nunavut is 3 times the national average, and twice that of the neighbouring territory, the Northwest Territories. Willinger M, James LS, Catz C: Defining the sudden infant death syndrome (SIDS): deliberations of an expert panel convened by the National Institute of Child Health and Human Development. Approximately 45% of births to Nunavut residents occur out of territory [9]. In Chukotka (Russian Federation) and Nunavut (Canada) the infant mortality was notably higher than the overall Arctic average: about 20 infant deaths per 1 000 live births. Although our data are limited, our results are consistent with other studies that suggest bed-sharing with additional risk factors present increases risk for SIDS/SUDI [18, 19]. High levels of prenatal exposure to cigarette smoke increases the risk of premature birth [41, 43]. Health promotion strategies must consider cultural perspectives and a strong emphasis on risk reduction is crucial [35]. 0000073030 00000 n Population stratification as an underlying determinant of this association needs further assessment, as does the association of other potentially interactive risk factors. Mothers who reported smoking greater than 10 cigarettes per day during pregnancy had twice the risk of having a premature infant than those who did not smoke [43]. CPT1A is an important liver enzyme required to transport long chain fatty acids into the mitochondrion for use as energy when dietary carbohydrates are unavailable (i.e. Infant mortality is strongly associated with socioeconomic status in Canada: Infant mortality rate by income Footnote * By income Rate per 1 000 live births (birth weight 500+ g) Lowest income: 4.7 : Nunavut’s infant mortality rate is nearly five times higher than the national average. Indoor air quality risk factors for severe lower respiratory tract infections in Inuit infants in Baffin Region, Nunavut: a pilot study. Statistics Canada: Table 051–0054 - Births by census division and sex for the period from July 1 to June 30, based on the Standard Geographical Classification (SGC) 2006, annual (persons), CANSIM (database). q8�(T�)�]� hr�2A�֩��D� We also compare Nunavut rates to published national data for similar years available through the Public Health Agency of Canada [29]. 0000080847 00000 n 2011, [http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1024304&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=]. Nunavut, a northern Canadian territory covering the most northern and eastern area of Canada, is Canada’s largest jurisdictional land mass with Causes and risk factors for infant mortality in Nunavut, Canada 1999–2011 | springermedizin.de 0000069169 00000 n While the infant mortality rate in Canada has improved over the past few decades, this improvement is not equally distributed. Reducing the risk from one factor may decrease the overall risk of SIDS. Boles RG, Buck EA, Blitzer MG, Platt MS, Cowan TM, Martin SK, Yoon H, Madsen JA, Reyes-Mugica M, Rinaldo P: Retrospective biochemical screening of fatty acid oxidation disorders in postmortem livers of 418 cases of sudden death in the first year of life. 2010, 182: 243-248. The infant mortality rate is the number of infant deaths per 1,000 live births. Arbour L, Gilpin C, Millor-Roy V, Platt R, Pekeles G, Egeland GM, Hodgins S, Eydoux P: Heart defects and other malformations in the Inuit in Canada: a baseline study. Crude mortality rates were calculated per 1,000 live births by region and for Nunavut [28, 31]. Factors such as sleep position and bed-sharing may play a role in these deaths. There is suggestion of protective effect for cardiovascular lipid profiles and obesity in the Alaska Yupik and Greenland Inuit adults, perhaps in the context of a traditional diet [25, 26]. ��I��}L�-}T��(:KV��p�%��NF��a�*��Be��{��{��S_��%��eNVL�W��B?FZE2�CRv!u��z�C��e �]c)Vcw�5�()��l��n�ɭ�k��u��ld V��Ұ��X9��oWZ��sG��L��Q��'�[�m��[㞘^��(Rg�*�r��s^�P'٣#Oq|��U�P��ⰶOP|9�1�Q�g=�?��ٷ�S�gQ �X��zRy]��H�K^�R��o;�sX��+"v�h��&�[�E]�(�}3q��Qm��uO�7�z:O��kO�hl�|`�Ə6�7 -�-Ce[�y��7��^�915��Ȗ�&�B_�o�Ue�? ! The remaining 17 were genotyped on request of the Chief Coroner or pathologist performing the autopsy. 0000070797 00000 n PubMed This initiative is being introduced as a way to combat Nunavut’s high infant mortality rates. Kovesi TA, Cao Z, Osborne G, Egeland GM: Severe early lower respiratory tract infection is associated with subsequent respiratory morbidity in preschool Inuit children in Nunavut, Canada. 2004, 63 (Suppl 2): 80-85. 0000076746 00000 n BMC Pediatr 12, 190 (2012). 2011, [http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1024501&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=]. 0000070072 00000 n 2002, 110: e64-10.1542/peds.110.5.e64. 1999, 68: 424-440. Nunavut’s infant mortality rate is nearly five times higher than the national average. In 2004, the Manitoba Newborn Screening program commenced a pilot CPT1A P479L newborn screening program for infants born to Kivalliq region residents [30]. The infant mortality rate in Nunavut is 3 times the national average, and twice that of the neighbouring territory, the Northwest Territories. Overall, infant mortality rates have significantly decreased all over the world. In our review, many SIDS/SUDI case reports did not include full information on sleep environment at time of death. Luo Z-C, Senecal S, Simonet F, Guimond E, Penney C, Wilkins R: Birth outcomes in the Inuit-inhabited areas of Canada. Better information regarding infant sleep practices in the overall population and at time of death is needed to assess risk effectively. Full ascertainment for CPT1A P479L genotype, sleep position and bed-sharing was not possible. [http://www12.statcan.ca/census-recensement/2006/as-sa/97-558/index-eng.cfm?CFID=78991&CFTOKEN=71134813], Statistics Canada: Table 102–0507 - Infant mortality, by age group, Canada, provinces and territories, annual, CANSIM (database). %PDF-1.4 %�� The review was conducted in partnership with Nunavut Tunngavik Inc. All infant deaths (live birth with death before 1 year of age) occurring in Nunavut between July 1, 1999 and June 30, 2011 and reported to the Nunavut Chief Coroner’s Office and, subsequently, to the Nunavut Chief Medical Officer of Health, were reviewed. Nunavut’s infant mortality rate is nearly five times higher than the national average. SIDS/SUDI (n=52, 58%) and infection (n=22, 25%) were the leading causes of postneonatal death in Nunavut (Figure 1). Cookies policy. Indeed, all postneonatal deaths in our review were born to Inuit mothers, which may have a higher homozygosity rate than the whole Qikiqtani region. 0000073189 00000 n 10.1542/peds.2011-2924. There were 21.4 infant deaths per 1,000 live births in Nunavut in 2012. The infant mortality rates in the Northwest Territories and Nunavut are well above the Canadian average. On-going assessment of the multiple risk factors involved in infant mortality will inform public health policy and prevention. The territory also has Canada’s highest rate of infant mortality. While it is controversial whether bed-sharing (sharing a sleep surface with an infant) is a risk factor itself, bed-sharing is associated with increased risk for SIDS when combined with other risk factors, including non-supine sleep position, bed-sharing with a non-caregiver and bed-sharing with a parent/caregiver who smokes or has impaired arousal [18, 19]. 10.1001/jama.284.7.843. 0000075349 00000 n Lancet. Given the high frequency of the variant in Inuit populations pointing to an historical advantage, the current clinical significance of the variant remains unclear. 10.1503/cmaj.051096. 10.1016/j.ymgme.2010.07.013. 420 0 obj <> endobj 0000074141 00000 n 10.1056/NEJMra0803836. 0000072598 00000 n SIDS and deaths due to infections have been previously identified as the leading contributors to the higher rates of postneonatal mortality in indigenous populations of Western Australia and Alaska [33, 34]. 2004, 63 (Suppl 2): 242-247. Carnitine palmitoyltransferase 1 deficiency, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=0510001&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www12.statcan.ca/census-recensement/2006/as-sa/97-558/index-eng.cfm?CFID=78991&CFTOKEN=71134813, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1020507&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1024304&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1024501&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www.phac-aspc.gc.ca/rhs-ssg/survey-eng.php, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=0510054&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www.phac-aspc.gc.ca/rhs-ssg/phi-isp-2011-eng.php, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1024512&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www.phac-aspc.gc.ca/publicat/2008/cphr-rspc/index-eng.php, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=0510053&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www.biomedcentral.com/1471-2431/12/190/prepub. 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